Individual
STEPHEN MARICICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10900 EUCLID AVENUE, CASE WESTERN RESERVE UNIVERSITY SOM ROOM E750I, CLEVELAND, OH 44106
(216) 368-2194
(216) 368-4650
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
35-091986
OH
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
M3010
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179389501
—
TX
05
—
2842651
—
OH
Enumeration date
10/17/2006
Last updated
10/01/2012
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